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The effect of a low carbohydrate diet on the compensation of type 2 diabetes mellitus
Sedlářová, Lenka ; Sucharda, Petr (advisor) ; Sadílková, Aneta (referee)
Type 2 diabetes mellitus (T2D) is a chronic metabolic disease characterized by insulin resistance and several secondary complications. The prevalence of patients is constantly increasing, and thus the effort to improve the quality of therapy, new findings, and procedures capable of being applied in clinical practice are sought. Patients live with the disease for a long time, and the purpose of treatment is to improve the quality of life of diabetics and delay the onset of associated health complications. A combination of regimen measures is essential for successful treatment. Dietary measures in the form of a low-carbohydrate diet are still a popular choice of dietary options among diabetics. The aim of the practical part of the work was to prove the positive effect of a low- carbohydrate diet on T2D compensation. The primary objective was to demonstrate a significant reduction in glycated hemoglobin (HbA1c) in patients who eat or have eaten according to the principles of a low-carbohydrate diet for at least 12 months. Secondary objectives were set as follows: reduction of relative weight (BMI), reduction of pharmacotherapy and/or reduction of daily doses of antidiabetic drugs, reduction of fasting blood glucose and improvement of the lipid spectrum. The research group included patients from the...
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Neuropathic complications and nutrition in patients with type 2 diabetes
Klauzová, Dagmar ; Prázný, Martin (advisor) ; Karen, Igor (referee)
Introduction: Diabetic neuropathy is a chronic complication of diabetes that decreases the quality of life of diabetic patients, mainly because there is currently no effective treatment for diabetic neuropathy and it increases the risk of developing other complications (e. g. diabetic foot syndrome). The development of late complications of diabetes can be delayed by preventive practices, and therefore, it is necessary to focus on prevention and raise awareness among patients about the possible complications associated with diabetes and how to prevent them. Objectives: The aim of this study was to investigate whether lifestyle and dietary habits differ between patients with type 2 diabetes with diabetic peripheral neuropathy and those without diabetic peripheral neuropathy. Methodology: Data collection was done using a self-administered questionnaire with a weekly dietary record. The questionnaire also included a validated sensorimotor neuropathy questionnaire. The questionnaire was distributed on the social media to a closed group of patients with DM2T and was personally offered to patients from the III. Department of Internal Medicine - Endocrinology and Metabolism of the 1st Faculty of Medicine of the Charles University in Prague, specifically at the VFN Clinic in the ambulance of Obesitology...
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Peptides regulating food intake and their role in metabolic syndrome
Buderová, Markéta ; Maletínská, Lenka (advisor) ; Hojná, Silvie (referee)
Unhealthy lifestyle together with genetic factors can lead to serious health problems like metabolic syndrome (MetS). MetS is a cluster of risk factors such as abdominal obesity, dyslipidemia, insulin resistance and hypertension. Each component of MetS contributes to cardiovascular diseases, type 2 diabetes mellitus (T2DM) and non-alcoholic fatty liver disease. Treatment of MetS is primarily focused on lifestyle modification, especially weight loss. In severe cases, pharmacological treatment is also used. Pharmacological treatment includes peptide analogues that regulate food intake. Anorexigenic (food- reducing) peptides are involved in the regulation of food intake, together with orexigenic (food- increasing) peptides, which thus play an important role in maintaining energy homeostasis. Several analogues of anorexigenic peptides regulating food intake are already used for the treatment of obesity or T2DM. Other peptide analogues are in preclinical stages of testing or in the development of stable analogues. Elucidating the physiology and pathology of both anorexigenic and orexigenic peptides in the regulation of food intake may contribute to finding potential treatments for metabolic, cardiovascular, and other disorders.
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Tcf4 transcription factor in the intestinal epithelium renewal and pathology
Müllerová, Tereza ; Janečková, Lucie (advisor) ; Vávra, Jiří (referee)
TCF4 (T-Cell Factor 4, sometimes also TCF7L2) is an important effector of the canonical Wnt signalling pathway. The transcription factor is produced in many different isoforms with tissue-specific expressionand diametricallyopposing functions.In the intestine,TCF4 is a key factor in epithelial regenerationandmaintenance of stem cell homeostasis. Its depletion causes loss of the proliferatingcrypt compartment and complete breakdown of the intestinal mucosal architecture. The processes in which it acts are therefore vital and must be strongly regulated by the Wnt signalling pathway. Disturbances in TCF4 expression or alternative splicing often lead to a wide range of complex pathologies such as colon cancer, ileal Crohn's disease and type 2 diabetes mellitus.
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Obesity and sleep apnea syndrome
Havrdová, Kateřina ; Matoulek, Martin (advisor) ; Svačina, Štěpán (referee)
Introduction: Obstructive sleep apnea (OSA) is characterized by repeated, complete or partial, obstructions of upper respiratory tract while asleep with accompanied apneic pauses. Interruption of ventilation and the subsequent waking reactions cause fragmented and low-quality sleep in the long term and the simultaneous decline in oxygen saturation of hemoglobin causes development of intermittent hypoxia, which leads to serious complications in patients with sleep apnea. One of the most important etiopathogenic factors in development of obstructive sleep apnea is obesity, mainly central and android obesity. It is estimated that obese patients with BMI ≥ 40 kg/m2 suffer from OSA in over 40-60 % cases and 70 % of patients with OSA are obese. According to current findings, both the maladies influence each other and form a positive feedback loop, which further complicates the whole situation. Aim: The aim of this thesis is to describe the relationship between obesity and obstructive sleep apnea on a set of patients, who were hospitalized in department D3 of III. Internal clinic of Všeobecná fakultní nemocnice v Praze (General university hospital in Prague) for suspicions for diagnosis of obstructive sleep apnea. The main tasks of the practical part of this thesis were to try to find a correlation...
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Lipidomic analysis of adipose tissue in patients with ischemic heart disease
Tomášová, Petra ; Vecka, Marek (advisor) ; Poledne, Rudolf (referee) ; Neckář, Jan (referee)
The ever-increasing incidence of coronary artery disease (CAD) in Czech Republic and worldwide is one of the most important health problem today. Obesity and type 2 diabetes mellitus (DM2T) are risk factors for the development of CAD. Lipid metabolism is greatly affected by these diseases and adipose tissue, previously considered a mere energy store, also plays an important role in these changes. Today adipose tissue is discussed also as an endocrine organ, which effect whole body metabolism significantly. Lipidomic analysis is an effective tool for monitoring lipid metabolism. Lipidomics combines the advantages of determining a large number of analytes and a small amount of sample and its rapid preparation. In the first part of study, I optimized the HPLC-MS method of untargeted lipidomic analysis in adipose tissue. Then, this method was used to compare subcutaneous and epicardial adipose tissue. Finally, I evaluated the effect of CAD and DM2T on the lipid profiles of subcutaneous and epicardial adipose tissues. Optimization of the pre-analytical phase enabled the analysis of 206 lipid molecules (in total) in both types of adipose tissue. Compared to subcutaneous adipose tissue, epicardial adipose tissue contained a higher proportion of phosphatidylcholines (e.g. PC(32:0), PC(32:1), PC(36:4)) and...
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Development of mortality on diabetes mellitus in developed countries, focusing on the Czech Republic
Koňařík, Martin ; Burcin, Boris (advisor) ; Hulíková Tesárková, Klára (referee)
Development of mortality on diabetes mellitus in developed countries, focusing on the Czech Republic Abstract This thesis addresses the development of diabetes mellitus mortality in selected developed countries between 1950 and 2008 and compares this development with the situation in Czechoslovakia, the Czech Republic respectively. This development is analyzed by sex, age and type of diabetes. Furthermore it also deals with diabetes morbidity and the share of diabetes mortality from the total mortality. The main approach used in this thesis is analysis of standardized mortality rates and this analysis was done both for whole long-term time series and time series within each International Classification of Diseases for individual countries. Based on the results, it was found that the development of diabetes mellitus mortality was similar across selected countries. It could be divided into several phases. Differentiation between mortality rates of males and females that occurred during reference period was so significant that mortality rates of females which were always higher had dropped below the rates of males. This effect is called in this thesis as a transition from higher female mortality to higher male mortality and it occurred in different countries at different times and also had variable-length...
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New regulatory metabolic factors in patients with obesity and type 2 diabetes mellitus
Matějková, Mirka ; Haluzík, Martin (advisor) ; Flachs, Pavel (referee)
Fibroblast growth factors are proteins with diverse biological function in development, tissue repair, and metabolism. The human FGF gene family consists of 22 members. FGF 19 subfamily includes FGF 19, FGF 21, and FGF 23. They act as systemic factors in an endocrine manner. FGF 19 subfamily requires klotho protein as a cofactor for its action. FGF 19 produced by intestine acts mainly in the liver through FGFR4, where it inhibits bile acid and fatty acid synthesis. FGF 21 is produced by the liver and contributes to the regulation of carbohydrate and lipid metabolism through modulation of glucose uptake in adipocytes. Serum FGF 21 levels are increased in patients with obesity and type 2 diabetes mellitus. Serum FGF 19 levels are on the contrary decreased in patients with obesity and type 2 diabetes mellitus and more probably depend on the nutritional status of the organism than on the glucose metabolism and insulin sensitivity. Key words: type 2 diabetes mellitus, FGF 19, FGF 21, obesity, adipose tissue
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Low carbohydrate diet in type 2 diabetes mellitus therapy
Kábelová, Adéla ; Krejčí, Hana (advisor) ; Šeda, Ondřej (referee)
Type 2 diabetes mellitus (T2D) is a highly prevalent metabolic disorder, which substantially affects quality of patients' lives and simultaneously increases the risk of early death due to development of its specific complications. Current T2D therapy comprises mainly pharmacotherapy, however, lifestyle changes, particularly modification of dietary habits, also assume an important role in the process. While conventional dietotherapy of T2D primarily concerns reduction of dietary fat intake aiming to achieve caloric restriction, the low carbohydrate diet (LCD), recently often discussed in relation to T2D therapy, is based on the reduction of dietary carbohydrates, whereas fats and/or proteins are increased. The positive effects of LCD in T2D therapy and its comorbidities are summarized in the theoretical part of this thesis. The aim of the practical part of the bachelor thesis was to asses the effect of LCD on health parameters associated with T2D as well as the subjective sense of respondents' satisfaction with this diet together with their adherence and compliance. The results of the survey showed that LCD led to weight loss, decreased waist circumference, glycaemia and levels of glycated haemoglobin and led, in a number of cases, to medication reduction. The level of satisfaction with LCD in the...
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